(O-I6) Application of Anti-barotrauma System in Hyperbaric Oxygen Therapy for Patients Visiting Emergency Department

Objectives: Barotrauma is the most common complication during hyperbaric oxygen therapy(HBOT), and to prevent barotrauma during HBOT, authors developed a barotrauma early detection system (AntiBaroTrauma: ABT). The purpose of this study is to check whether early detection of barotrauma is possible when applying the ABT system to hyperbaric oxygen therapy.

Background: HBOT is required in many emergency situations such as fires, chemical accidents, CO intoxication and dysbarism. During HBOT, patients are usually required to perform pressure control efforts such as Valsalva maneuver periodically, and medical staff communicate with patients to check their condition, such as occurrence of ear pain to prevent barotrauma. However, if barotrauma causes ear pain, barotrauma has already progressed, so researchers have been looking for ways to detect barotrauma before symptoms occur. We developed a headset-type barotrauma early detection system and applied it to patients receiving hyperbaric oxygen therapy to identify its effectiveness, advantages and disadvantages.

Methods: The study was conducted in the form of a single-blinded prospective parallel randomized controlled study for two years from January 2021 to December 2022 in patients aged 18-65 years visiting one government-affiliated regional emergency center and receiving hyperbaric oxygen therapy. Pregnant women, pneumothorax, respiratory symptoms and diseases, high fever, history of thoracic/ear surgery, claustrophobia and other academic and clinical contraindications were excluded. Both test and control groups were pressurized to >2.4 atm during hyperbaric treatment, with ABT applied in the test group and regular questioning of patients by medical staff during pressurization in the control group to determine discomfort. Number of treatment interruptions/completions due to pressure damage, otoscopic findings (Edmond's Score Grade 0~5), ear pain scale, and satisfaction of patient based on questionnaire were evaluated,

Results: The test group utilizing ABT had a longer pressurization time than the control group. In video otoscopic findings, Edmond's Score Grade increased less in the test group, but there was no statistical difference between the two groups. The test group took more pressurization time and total treatment time than the control group.

Conclusions: ABT allows for early detection of barotrauma compared to traditional periodic patient checks, but may add to pressurization time and total treatment time, and can reduce provider effort to check on patients during pressurization.

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Funding (Optional): This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number: KMDF_PR_20200901_0000 ) (NTIS, KMDF-RnD 202014X24)